Apparatus, systems, and methods for simulating urinary procedure(s)

ABSTRACT

Apparatus, systems, and methods according to which simulated urinary procedure(s) may be performed.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.16/242,700, filed Jan. 8, 2019, which claims the benefit of the filingdate of, and priority to, U.S. Application No. 62/617,020, filed Jan.12, 2018, the entire disclosures of which are hereby incorporated hereinby reference.

TECHNICAL FIELD

This disclosure is related in general to interactive education systemsfor teaching patient care, and, more particularly, to an interactivepatient for simulating thoracic, urinary, pulmonary, and capillaryprocedures.

BACKGROUND

As medical science has progressed, it has become increasingly importantto provide non-human interactive formats for teaching patient care.While it is desirable to train medical personnel in patient careprotocols before allowing contact with real patients, textbooks andflash cards lack the important benefits to students that can be attainedfrom hands-on practice. On the other hand, allowing inexperiencedstudents to perform medical procedures on actual patients that wouldallow for the hands-on practice cannot be considered a viablealternative because of the inherent risk to the patient. Non-humaninteractive devices and systems can be used to teach the skills neededto successfully identify and treat various patient conditions withoutputting actual patients at risk.

For example, patient care education has often been taught using medicalinstruments to perform patient care activity on a physical simulator,such as a manikin—a manikin may be a life-sized anatomical human modelused for educational and instructional purposes. Such training devicesand systems can be used by medical personnel and medical students toteach and assess competencies such as patient care, medical knowledge,practice based learning and improvement, systems based practice,professionalism, and communication. The training devices and systems canalso be used by patients to learn the proper way to performself-examinations. However, existing simulators fail to exhibit accuratesymptoms and to respond appropriately to student stimuli, therebyfailing to provide realistic medical training to the students. Existingsimulators also fail to look and feel lifelike, which fails to improvethe training process. Thus, while existing physical simulators have beenadequate in many respects, they have not been adequate in all respects.As such, there is a need to provide a simulator for use in conductingpatient care training sessions that overcomes the above deficiencies ofexisting stimulators by, for example, being even more realistic and/orincluding additional simulated features.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a manikin, according to variousembodiments of the present disclosure.

FIG. 2 is a block diagram schematically illustrating a patientsimulator, which may be implemented at least in part within theenvironment and/or the manikin of FIG. 1, according to variousembodiments of the present disclosure.

FIG. 3 is a block diagram schematically illustrating a thoracostomysystem, which may be implemented at least in part within the manikin,the patient simulator, and/or the respective environments of FIGS. 1 and2, the thoracostomy system including, inter alia, a simulated thoracicsite, according to various embodiments of the present disclosure.

FIG. 4 is an exploded perspective view of a portion of the simulatedthoracic site of FIG. 3, according to various embodiments of the presentdisclosure.

FIG. 5 is an exploded perspective view of another portion of thesimulated thoracic site of FIG. 3, according to various embodiments ofthe present disclosure.

FIG. 6 is a cross sectional view of the simulated thoracic site of FIG.5, according to various embodiments of the present disclosure.

FIG. 7 is a block diagram schematically illustrating a simulated urinarysystem, which may be implemented at least in part within the manikin,the patient simulator, and/or the respective environments of FIGS. 1 and2, according to various embodiments of the present disclosure.

FIG. 8 is a block diagram schematically illustrating a simulatedrespiratory system, which may be implemented at least in part within themanikin, the patient simulator, and/or the respective environments ofFIGS. 1 and 2, according to various embodiments of the presentdisclosure.

FIG. 9 is an exploded perspective view of a capillary device, which maybe implemented at least in part within the environment and/or themanikin of FIG. 1, according to various embodiments of the presentdisclosure.

FIG. 10 is a cross sectional view of the capillary device of FIG. 9,according to various embodiments of the present disclosure.

DETAILED DESCRIPTION

For the purposes of promoting an understanding of the principles of thepresent disclosure, reference will now be made to the embodimentsillustrated in the drawings, and specific language will be used todescribe the same. It will nevertheless be understood that no limitationof the scope of the disclosure is intended. Any alterations and furthermodifications to the described devices, instruments, methods, and anyfurther application of the principles of the present disclosure arefully contemplated as would normally occur to one skilled in the art towhich the disclosure relates. In particular, it is fully contemplatedthat the features, components, and/or steps described with respect toone embodiment may be combined with the features, components, and/orsteps described with respect to other embodiments of the presentdisclosure. For the sake of brevity, however, the numerous iterations ofthese combinations will not be described separately. For simplicity, insome instances the same reference numbers are used throughout thedrawings to refer to the same or like parts.

One of the aims of healthcare simulation is to establish a teachingenvironment that closely mimics key clinical cases in a reproduciblemanner. The introduction of high fidelity tetherless simulators, such asthose available from Gaumard Scientific Company, Inc., over the past fewyears has proven to be a significant advance in creating realisticteaching environments. The present disclosure is directed to aninteractive education system for teaching patient care that expands thefunctionality of the patient simulators by increasing the realism of thelook, feel, and functionality of the patient simulators that can be usedto train medical personnel in a variety of clinical situations. Theinteractive education system disclosed herein offers a training platformon which team-building scenarios can be performed for the development ofmedical treatment skills and the advancement of patient safety.

In particular, the interactive education system disclosed herein mayinclude, or be part of, a patient simulator to provide improved realismand functionality compared to previously available simulators. Some ofthe various features that facilitate the improved realism andfunctionality are described in detail below. The interactive educationsystem of the present disclosure allows users to practice a range ofdifferent scenarios. Thus, the interactive education system facilitatesthe training of a user across a broad range of simulated scenarios andcorresponding assessment of the user's response to the differentsimulated scenarios. Accordingly, the user's medical treatment skillscan be obtained and/or improved in a simulated environment withoutendangering a live patient.

In various embodiments, the patient simulator of the present disclosurerealistically simulates thoracic, urinary, pulmonary, and/or capillaryprocedures in a way that replicates a live patient's clinical behaviorand is therefore useful for medical educational and diagnostic purposes.To this end, the patient simulator may include a thoracostomy systemhaving a simulated thoracic site on which a simulated thoracostomyprocedure can be performed, as described in further detail herein.Further, the patient simulator may include a simulated urinary systemhaving a simulated catheterization site on which a simulated urinarycatheterization procedure can be performed, as described in furtherdetail herein. Further still, the patient simulator may include asimulated respiratory system having simulated left and right lungs incommunication with a simulated airway system—in combination, thesimulated respiratory system and the simulated airway system facilitatea simulated pulmonary procedure, such as, for example a ventilationprocedure, as described in further detail herein. Finally, the patientsimulator may include a capillary device on which, for example, asimulated finger stick procedure can be performed, as described infurther detail herein.

Moreover, in various embodiments, the interactive education systemallows for multiple users to simultaneously work with the patientsimulator during a particular scenario, thereby facilitating teamtraining and assessment in a realistic, team-based environment. Byallowing multiple users to simultaneously interact with the interactiveeducation system, the system facilitates the real-time training andassessment of the cooperative efforts of a team in a wide variety ofscenarios, such as, by way of non-limiting example, a fire in thehospital. In various embodiments, the interactive education systemprovides for pre-operative care simulation as well as post-operativecare simulation, thereby allowing users to experience, address, andassess pre-operative and post-operative management, includingpre-operative acquisition of the patient history and management ofpost-operative complications.

For example, in various embodiments, the interactive education systemallows for the realistic reception and transport of the patientsimulator through a hospital (e.g., from an emergency room to anoperating room) during operation of a particular scenario. In addition,the interactive education system can be used to conduct patient safetydrills in an actual hospital or other medical setting.

In various embodiments, the interactive education system includesfeatures designed to enhance the educational experience. For example, invarious embodiments, the system includes a processing module (e.g., amicroprocessor circuit or the like) to simulate different medical and/orsurgical scenarios during operation of the interactive education system.In various embodiments, the system includes a camera system that allowsvisualization of the procedure for real-time video and log capture fordebriefing purposes. In various embodiments, the interactive educationsystem is provided with a workbook of medical scenarios that arepre-programmed in an interactive software package, thereby providing aplatform on which team-building scenarios can be performed for thedevelopment of medical treatment skills and general patient safety.Thus, the interactive education system disclosed herein provides asystem that is readily expandable and updatable without large expenseand that enables users to learn comprehensive medical and surgicalskills through “hands-on” training, without sacrificing the experiencegained by users in using standard surgical instruments in a simulatedpatient treatment situation.

Referring initially to FIG. 1, in some embodiments, the patientsimulator system is, includes, or is part of, a manikin 101 in the formof a human body (e.g., a simulated pediatric patient)—the manikin 101may include a simulated head 103, a simulated neck 105, a simulatedtorso 107, simulated arms 109 a and 109 b, simulated hands 111 a and 111b, simulated legs 113 a and 113 b, simulated feet 115 a and 115 b,and/or simulated skin 117. The simulated neck 105 is connected to thesimulated torso 107. The simulated head 103 is connected to thesimulated neck 105. The simulated arms 109 a and 109 b are connected tothe simulated torso 107. The respective simulated hands 111 a and 111 bare connected to the simulated arms 109 a and 109 b. The simulated legs113 a and 113 b are connected to the simulated torso 107. The respectivesimulated feet 115 a and 115 b are connected to the simulated legs 113 aand 113 b. The simulated skin 117 may be part of the simulated head 103,the simulated neck 105, the simulated torso 107, the simulated arms 109a and 109 b, the simulated hands 111 a and 111 b, the simulated legs 113a and 113 b, the simulated feet 115 a and 115 b, and/or any combinationthereof.

Turning also to FIG. 2, with continuing reference to FIG. 1, a blockdiagram of the patient simulator according to some embodiments of thepresent disclosure is schematically illustrated and generally referredto by the reference numeral 201. The patient simulator 201 may beimplemented (at least in part) within the environment and/or the manikin101 of FIG. 1. The patient simulator 201 includes a microprocessorcircuit (or microcontroller) 203, an electronic memory 205, and aninput/output (“I/O”) interface 207. The microprocessor circuit 203 mayinclude an integrated circuit (e.g., ASIC), and may be programmed withappropriate software to allow and enable the simulated features of thepatient simulator 201. The I/O interface 207 may include, or facilitatecommunication with, peripheral input devices like a keyboard, mouse andjoystick, and output devices such as a display, speakers, and a printer.The microprocessor circuit 203 may exchange information with connectedcomponents (internal and external) by using a Universal Serial Bus(USB), a one-wire RS-232 communication interface, or an I2Ccommunication interface.

In some embodiments of the patient simulator 201, one of which is shownimplemented (at least in part) within the environment and/or the manikin101 of FIG. 1, the patient simulator 201 includes one, or a combination,of the following: a thoracostomy system 209, a simulated urinary system211, and/or a simulated respiratory system 213. The microprocessorcircuit 203 may be configured to be in electronic communication withrespective components of the thoracostomy system 209, the simulatedurinary system 211, and/or the simulated respiratory system 213, asshown in FIG. 2. More particularly, the microprocessor circuit 203 maybe configured to monitor, or control, the thoracostomy system 209, thesimulated urinary system 211, and/or the simulated respiratory system213 via said electronic communication.

In some embodiments, as shown in FIG. 2, the thoracostomy system 209includes one, or a combination, of the following: a chest tube sensor301, a chest fluid valve 303, and/or a chest fluid pump 305, eachconfigured for electronic communication with the microprocessor circuit203. For example, turning to FIG. 3, with continuing reference to FIG.2, in at least one such embodiment, the thoracostomy system 209 includesthe chest tube sensor 301 and the chest fluid valve 303, but not thechest fluid pump 305. As shown in FIG. 3, the thoracostomy system 209may also include a simulated thoracic site 307, a chest fluid reservoir309, and a filling port 311. The simulated thoracic site 307 isconfigured for insertion of a chest tube, as described in further detailherein. The chest tube sensor 301 is operably coupled to the simulatedthoracic site 307 and configured to detect insertion of the chest tube.In addition to, or instead of, being configured for electroniccommunication with the microprocessor circuit 203, the chest tube sensor301 may be configured for electronic communication directly with thechest fluid valve 303, as indicated by arrow 313 in FIG. 3.

The chest fluid valve 303 includes fluid ports P1, P2, and P3. The portP1 of the chest fluid valve 303 is in fluid communication, via a flowpath L1, with the simulated thoracic site 307. The port P2 of the chestfluid valve 303 is in fluid communication, via a flow path L2, with thechest fluid reservoir 309. The port P3 of the chest fluid valve 303 isin fluid communication, via a flow path L3, with the filling port 311.The flow path L3 includes a check valve 315 configured to allow fluidcommunication from the filling port 311 to the port P3 of the chestfluid valve 303, but to prevent reverse fluid communication from theport P3 of the chest fluid valve 303 to the filling port 311. The chestfluid valve 303 is configurable between a first configuration, in whichthe port P1 communicates with the port P2, but not the port P3, and asecond configuration, in which the port P2 communicates with the portP3, but not the port P1.

In some embodiments, as shown in FIG. 3, the chest fluid reservoir 309includes an expandable vessel 317 (e.g., an accordion- or bellows-typebag) enclosed within an expansion chamber 319. The expandable vessel 317is configured to be filled with simulated pleural fluid via the fillingport 311, and is actuable between a fully-collapsed (or empty) state anda fully-expanded (or full) state within the expansion chamber 319. Theexpansion chamber 319 contains one or more biasing members 321 (e.g.,springs, gas pistons, or the like) configured to bias the expandablevessel 317 towards the fully-collapsed state. In some embodiments,conical or tapered springs are used to reduce the overall space requiredfor the chest fluid reservoir 309. In addition to, or instead of, theone or more biasing members 321, the expandable vessel 317 may beconfigured to bias itself towards the fully-collapsed state. Theexpansion chamber 319 may be defined at least in part by a housing 323(e.g., made of urethane)—in some embodiments, the housing 323 includestwo pieces of urethane sealed tightly together so as to withstand thefluid pressure within the expandable vessel 317. This facilitatesrealistic simulation of blood gushing out of a thoracic incision in amanner similar to what might be observed during an actual thoracostomysurgery.

In operation, a chest tube is insertable into the simulated thoracicsite 307 to realistically simulate a thoracostomy procedure. The chesttube sensor 301 is configured to detect when the chest tube has beenfully inserted into the simulated thoracic site 307. Before the chesttube is fully inserted into the simulated thoracic site 307, the chestfluid valve 303 defaults to the second configuration in which the portP2 communicates with the port P3, but not the port P1. When the chestfluid valve 303 is in the second configuration, the check valve 315prevents communication of simulated pleural fluid from the expandablevessel 317 to the filling port 311, but allows communication ofsimulated pleural fluid from the filling port 311 to the expandablevessel 317. Thus, the filling port 311 may be used to fill theexpandable vessel 317 with simulated pleural fluid while the check valve315 prevents, or at least reduces, simulated pleural fluid from spillingout of the filling port 311.

Once the chest tube sensor 301 detects full insertion of the chest tubeinto the simulated thoracic site 307, the chest tube sensor 301communicates an electrical signal that causes the chest fluid valve 303to be actuated to the first configuration in which the port P1communicates with the port P2, but not the port P3. Thus, the chest tubesensor 301 is used as a triggering device that signals themicroprocessor circuit 203 (or the chest fluid valve 303 directly) toactuate the chest fluid valve 303 to the first configuration. When thechest fluid valve 303 is in the first configuration, the biasing members321 urge simulated pleural fluid out of the expandable vessel 317,through the flow path L2, the chest fluid valve 303 (via the ports P1and P2), and the flow path L1, and into the fully-inserted chest tube.Thus, the thoracostomy system 209 is operated by precisely controllingthe configuration of the chest fluid valve 303, along with the amount offluid contained within the chest fluid reservoir 309.

In some embodiments, the thoracostomy system 209 can be used torealistically simulate pneumothorax, which is the accumulation of air orgas in the pleural space. In some embodiments, the thoracostomy system209 can be used to realistically simulate pleural effusion, which is theaccumulation of liquid in the pleural space—the liquid could belymphatic fluid (i.e., chylothorax), blood (i.e., hemothorax), serousfluid (i.e., hydrothorax), or a pyogenic infection of the pleural space.More particularly, the thoracostomy system 209 may be operable torealistically simulate the drainage of pleural effusion, which, inexcess, can impair breathing by limiting expansion of the lung(s). Thecauses of pleural effusion are numerous, and may include, inter alia,congestive heart failure, collapsed lung(s), liver cirrhosis, trauma,empyema (i.e., collection of pus in the pleural space), parapneumoniceffusion due to pneumonia, cancer (i.e., lung cancer, breast cancer, orlymphoma), viral infection, and/or pulmonary embolism.

Referring to FIGS. 4-6, in some embodiments, the simulated thoracic site307 includes an insert 325 and a support housing 327. The insert 325 isconfigured to be detachably operably coupled, or connected, to thesupport housing 327. In some embodiments, the support housing 327 is“floated” during the injection molding procedure to ensure properorientation within the simulated skin 117 of the simulated torso 107.The insert 325 includes a skin layer 329, adipose tissue 331, a ribslayer 333 (e.g., made out of urethane), endothoracic fascia 335 (e.g.,able to hold fluid) (which may also be referred to as “intercostalmuscle”, “red muscle”, “muscle layer”, or the like), and a pleura cavity337. In some embodiments, the skin layer 329 is, includes, or is partof, the simulated skin 117 of the patient simulator system 10. The skinlayer 329 defines a pocket that receives at least one, or a combination,of the following: the adipose tissue 331, the ribs layer 333, theendothoracic fascia 335, and/or the pleura cavity 337. In someembodiments, the skin layer 329 acts as a container to hold the otherlayers together. In some embodiments, the skin layer 329 may include arim around the outside to promote a better fit with the support housing327.

The adipose tissue 331, the ribs layer 333, and the endothoracic fascia335 are sandwiched between the skin layer 329 and the pleura cavity 337,and the ribs layer 333 is sandwiched between the adipose tissue 331 andthe endothoracic fascia 335. The ribs layer 333 may be constructed so asto be palpitated though the skin layer 329 and the adipose tissue 331.The adipose tissue 331 engages the skin layer 329, and the endothoracicfascia 335 engages the pleura cavity 337. The endothoracic fascia 335(or red muscle layer) may be constructed with a small pocket into whicha user may introduce simulated blood through the use of a syringe andneedle—a small mark may be made on a side of the skin layer 329 toindicate where to introduce the simulated blood. The pleura cavity 337may be constructed using a combination of a mesh fabric embedded intoclear silicone, and may include parietal pleura and visceral pleura. Insome embodiments, the insert 325 bleeds when cut between the ribs layer333 on the midaxillary line of the simulated torso 107, allowing theescape of fluid and/or trapped air.

In some embodiments, as shown in FIGS. 5 and 6, the support housing 327includes locking cavities 339 configured to lock the insert 325 in placeby receiving anchoring legs 341 (shown in FIG. 4) extending, forexample, from the ribs layer 333 of the insert 325. The cavities 339 maycreate a friction locking mechanism with the anchoring legs 341 toprevent dislodgement of the insert 325 from the support housing 327during the simulated thoracostomy procedure. The support housing 327also includes an internal chamber 343 that provides empty space behindthe insert 325 for a user to check for the pleural space during thesimulated thoracostomy procedure to confirm that the chest tube is readyto be inserted. In some embodiments, the internal chamber 343 is roundor cylindrical in shape to allow the user to insert a finger and checkfor the surrounding area of the pleural space. The support housing 327also includes a funnel 345 adjacent the internal chamber 343 andconfigured to guide the chest tube towards the chest tube sensor 301 asthe chest tube is inserted through an incision made by the user in theinsert 325.

The thoracostomy system 209 also includes a sensor mount 347 to whichthe chest tube sensor 301 is mounted—the sensor mount 347 includes aninternal passage 348 that is in fluid communication with the port P1 ofthe chest fluid valve 303 (shown in FIG. 3). In some embodiments, thesensor mount 347 is a plastic tube having the chest tube sensor 301mounted to the outside thereof. As shown in FIGS. 5 and 6, the sensormount 347 is operably coupled to the support housing 327 adjacent thefunnel 345 via, for example, a sensor mount barb 349 so that the chesttube is insertable through the insert 325, the internal chamber 342, andthe funnel 345, and into the internal passage 348. The sensor mount 347is equipped with a sealing ring 351 positioned adjacent the internalpassage 348 and configured to seal against the chest tube when the chesttube is inserted into the internal passage 348. As a result, the sealingring 351 facilitates the flow of simulated pleural fluid from theexpandable vessel 317 into the fully-inserted chest tube by preventing,or at least reducing, migration of the simulated pleural fluid from theinternal passage 348, around the outside of the chest tube, and into theinternal chamber 343 of the support housing 327. Once the chest tube hasbeen inserted far enough into the internal passage 348, the chest fluidvalve 303 is triggered into the first configuration by the chest tubesensor 301. As previously described, triggering of the chest fluid valve303 into the first configuration causes simulated pleural fluid to flowout of the expandable vessel 317, through the flow path L2, the chestfluid valve 303 (via the ports P1 and P2), and the flow path L1, andinto the fully-inserted chest tube. In some embodiments, the sensormount 347 includes a quick-disconnect fitting 353.

In addition to, or instead of, the chest fluid valve 303, thethoracostomy system 209 may include the chest fluid pump 305—in suchembodiments, the chest fluid pump 305 may draw fluid actively out of thechest fluid reservoir 309, thus decreasing, or eliminating, the need forthe biasing member(s) 321 in the chest fluid reservoir 309. The chestfluid pump 305 may be a peristaltic pump. Moreover, in addition to, orinstead of, the chest tube sensor 301, the thoracostomy system 209 mayinclude a check valve in the form of the duck bill or flapper valvecombined with a membrane seal, similar to that described below inrelation to the simulated urinary system 211.

Referring back again to FIG. 2, in some embodiments, the simulatedurinary system 211 includes one, or a combination, of the following: acatheter sensor 401, a urinary valve 403, and/or a urinary pump 405,each configured for electronic communication with the microprocessorcircuit 203. For example, turning to FIG. 7, with continuing referenceto FIG. 2, in at least one embodiment, the simulated urinary system 211includes the urinary valve 403, but not the catheter sensor 401 or theurinary pump 405. As shown in FIG. 7, the simulated urinary system 211may also include a simulated catheterization site 407, a urinarymanifold 409, and a pair of urinary fluid reservoirs 411 and 413. Thesimulated catheterization site 407 is configured for insertion of aurinary catheter therethrough, and may take the form of either a male ora female urethral opening. The simulated urinary system 211 alsoincludes a check valve 415 operably coupled to the simulatedcatheterization site 407—the check valve 415 may take the form of a duckbill or flapper valve 417 combined with a membrane seal 419, as shown inFIG. 7. The check valve 415 is configured to permit insertion of theurinary catheter while preventing back-flow of simulated urinary fluid,as described in further detail herein.

The urinary valve 403 includes fluid ports P4 and P5, and is actuablebetween an open configuration, in which the fluid ports P4 and P5 are influid communication, and a closed configuration, in which the fluidports P4 and P5 are not in fluid communication. The urinary manifold 409includes fluid ports P6, P7, P8 and P9, each of which is in fluidcommunication with the others. The port P6 of the urinary manifold 409is in fluid communication, via a flow path L4, with the check valve 415.The port P7 of the urinary manifold 409 is in fluid communication, via aflow path L5, with the port P4 of the urinary valve 403. The port P5 ofthe urinary valve 403 is in fluid communication, via a flow path L6,with the urinary fluid reservoir 411. The port P8 of the urinarymanifold 409 is in fluid communication, via a flow path L7, with theflow path L6 extending between the port P5 of the urinary valve 403 andthe urinary fluid reservoir 411. The flow path L7 includes a check valve421 configured to allow fluid communication from the port P8 of theurinary manifold 409 to the flow path L6, but to prevent reverse fluidcommunication from the flow path L6 to the port P8 of the urinarymanifold 409. The port P9 of the urinary manifold 409 is in fluidcommunication, via a flow path L8, with the urinary fluid reservoir 413.

In some embodiments, one of which is shown in FIG. 7, the urinary fluidreservoirs 411 and 413 each include an expandable vessel 423 (e.g., anaccordion- or bellows-type bag) enclosed within an expansion chamber425. The expandable vessels 423 are configured to be filled withsimulated urinary fluid via, inter alia, the check valve 415, and areactuable between fully-collapsed (or empty) states and fully-expanded(or full) states within the respective expansion chambers 425. Theexpansion chambers 425 each contain one or more biasing members 427(e.g., springs, gas pistons, or the like) configured to bias therespective expandable vessels 423 towards the fully-collapsed state. Insome embodiments, conical or tapered springs are used to reduce theoverall space required for the urinary fluid reservoirs 411 and 413. Inaddition to, or instead of, the one or more biasing members 427, atleast one of the expandable vessels 423 may be configured to bias itselftowards the fully-collapsed state. The expansion chambers 425 may eachbe defined at least in part by a housing 429 (e.g., made of urethane)—insome embodiments, the housings 429 each include two pieces of urethanesealed tightly together so as to withstand the fluid pressure within therespective expandable vessels 423. This facilitates the simulation ofurine gushing out of a urethral opening in a manner similar to whatmight be observed during an actual urinary catheterization procedure.

In operation, a urinary catheter is insertable into the simulatedcatheterization site 407 to realistically simulate a urinarycatheterization procedure. The check valve 415 is configured to receivethe urinary catheter once the urinary catheter has been fully insertedinto the simulated catheterization site 407. Before the urinary catheteris received by the check valve 415, the urinary valve 403 defaults tothe closed configuration, in which the fluid ports P4 and P5 are not influid communication. When the urinary valve 403 is in the closedconfiguration, the urinary valve 403 prevents communication of simulatedurinary fluid from the urinary fluid reservoir 411 to the port P7 of theurinary manifold 409, and the check valve 421 prevents communication ofsimulated urinary fluid from the urinary fluid reservoir 411, via theflow path L7, to the port P8 of the urinary manifold 409. As a result,when the urinary valve 403 is in the closed configuration, communicationof simulated urinary fluid from the urinary fluid reservoir 411 to theurinary manifold 409 (and thus the check valve 415) is not permitted. Onthe other hand, communication of simulated urinary fluid from the checkvalve 415 to the urinary fluid reservoir 411 (e.g., to fill the urinaryfluid reservoir) is permitted via the check valve 421—the check valve415 may thus be used to fill the fluid reservoir 411 (and the fluidreservoir 413) with simulated urinary fluid when the urinary valve 403is in the closed configuration.

In order to be received by the check valve 415, in some embodiments, theurinary catheter must extend through the membrane seal 419 and at leastpartially into the duck bill or flapper valve 417. That is, the urinarycatheter must breach the duck bill or flapper valve 417 to allow theflow of simulated urinary fluid therethrough. Once the urinary catheterhas been received by the check valve 415, the urinary fluid reservoir413 is permitted to release an initial surge of simulated urinary fluidinto the urinary catheter. More particularly, the biasing member 427 ofthe fluid reservoir 413 urges simulated urinary fluid out of theexpandable vessel 423, through the flow path L8, the urinary manifold409 (via the ports P6 and P9), and the flow path L4, and into thefully-inserted urinary catheter. Since the urinary valve 403 defaults tothe closed configuration, in which the fluid ports P4 and P5 are not influid communication, the urinary valve 403 and the check valve 421together prevent the urinary fluid reservoir 411 from also releasingsimulated urinary fluid into the urinary catheter.

After the initial surge of simulated urinary fluid is released from theurinary fluid reservoir 413 into the urinary catheter, the urinary valve403 may be actuated to the open configuration, in which the fluid portsP4 and P5 are in fluid communication, to permit the release ofadditional simulated urinary fluid from the urinary fluid reservoir 411into the urinary catheter. Opening the urinary valve 403 allows thebiasing member 427 of the fluid reservoir 411 to urge simulated urinaryfluid out of the expandable vessel 423, through the flow path L6, theurinary valve 403 (via the ports P4 and P5), the flow path L5, theurinary manifold 409 (via the ports P6 and P7), and the flow path L4,and into the fully-inserted urinary catheter. In some embodiments, theurinary valve 403 is not opened until after the urinary fluid reservoir413 has been substantially emptied. The urinary valve 403 may be used asa metering device to control the release of simulated urinary fluid fromthe urinary reservoir 411 into the urinary catheter. The microprocessorcircuit 203 may be used to actuate the urinary valve 403 to between theopen and closed configurations. Thus, the simulated urinary system 211is operated by precisely controlling the configuration of the urinaryvalve 403, along with the amount of fluid contained within the urinaryfluid reservoirs 411 and 413. In some embodiments, following the initialsurge of simulated urinary fluid, additional simulated urinary fluid isoutput at a metered rate from the urinary reservoir 411—this rate can bedetermined by an instructor and effected by controlling the urinaryvalve 403 with the microprocessor circuit 203.

In some embodiments, the simulated urinary system 211 can be used torealistically simulate acute urinary retention or post-operative urinaryretention, which is a medical emergency in which the bladder can stretchto an enormous size—tearing of the bladder can occur if this situationis not dealt with quickly and properly. Once the bladder distends farenough, the patient experiences significant pain. Such an increase inbladder pressure can prevent urine from entering the ureters, and mayeven cause urine to flow back up through the ureters and into thekidneys, which can cause hydronephrosis, kidney failure, and sepsis.There is also an increased risk of urinary tract infection.

In addition to, or instead of, the urinary valve 403, the simulatedurinary system 211 may include the urinary pump 405—in such embodiments,the urinary pump 405 may draw fluid actively out of one, or both, of theurinary fluid reservoirs 411 and 413, thus decreasing, or eliminating,the need for the biasing member(s) 427. The urinary pump 405 may be aperistaltic pump. Moreover, in one such embodiment, in addition to, orinstead of, the check valve 415, the simulated urinary system 211 mayinclude the catheter sensor 401 operable in conjunction with a valve toinitiate the flow of simulated urinary fluid in a manner to similar tothat described herein in relation to the thoracostomy system 209.

Referring back again to FIG. 2, in some embodiments, the simulatedrespiratory system 213 includes one, or a combination, of the following:a left lung pump 501, a left lung valve 503, a right lung pump 505, aright lung valve 507, a compliance control valve 509, and/or a positiveend-expiratory pressure (“PEEP”) control system 511, each configured forelectronic communication with the microprocessor circuit 203. Forexample, turning to FIG. 8, with continuing reference to FIG. 2, in atleast one embodiment, the simulated respiratory system 213 includes thecombination of: the left lung pump 501, the left lung valve 503, theright lung pump 505, the right lung valve 507, the compliance controlvalve 509, and the PEEP control system 511. As shown in FIG. 8, thesimulated respiratory system 213 may also include a simulated airwaysystem 513, a simulated left lung 515, a left lung compliance reservoir517, a simulated right lung 519, and a right lung compliance reservoir521. The left and right lung compliance reservoirs 517 and 521 arepositioned adjacent the simulated left and right lungs 515 and 519,respectively—as a result, the volume of the left and right lungcompliance reservoirs 517 and 521 can be adjusted to change the lungcompliance of the simulated left and right lungs 515 and 519, asdescribed in further detail herein. In various embodiments, at leastone, or a combination, of the following may be, include, or be part ofan accordian- or bellows-type bag: the simulated left lung 515, the leftlung compliance reservoir 517, the simulated right lung 519, and/or theright lung compliance reservoir 521.

The left and right lung pumps 501 and 505 each include a cylinder 523and a piston 525 dividing the cylinder 523 into chambers 527 and 529.During the respective upward strokes of the pistons 525 (from right toleft as viewed in FIG. 8), the left and right lung pumps 501 and 505generate positive pressure in the respective chambers 527 and negative(vacuum) pressure in the respective chambers 529. Conversely, during thedownward stroke of the piston 525 (from left to right as viewed in FIG.8), the left and right lung pumps 501 and 505 generate negative (vacuum)pressure in the respective chambers 527 and positive pressure in therespective chambers 529.

The chamber 527 of the left lung pump 501 is in fluid communication, viaa flow path L9, with the simulated airway system 513, and the chamber529 of the left lung pump 501 is in fluid communication, via a flow pathL10, with the simulated left lung 515. The left lung valve 503 isconfigurable to communicate fluid from the flow path L9 to the flow pathL10, or vice versa—as a result, using the left lung valve 503, air flowmay be permitted to bypass the left lung pump 501 from the simulatedairway system 513 to the simulated left lung 515, or vice versa.Similarly, the chamber 527 of the right lung pump 505 is in fluidcommunication, via a flow path L11, with the simulated airway system513, and the chamber 529 of the right lung pump 505 is in fluidcommunication, via a flow path L12, with the simulated right lung 519.The right lung valve 507 is configurable to communicate fluid from theflow path L11 to the flow path L12, or vice versa—as a result, using theright lung valve 507, air flow may be permitted to bypass the right lungpump 505 from the simulated airway system 513 to the simulated rightlung 519, or vice versa. The controlled bypassing of the left and rightlung pumps 501 and 505 using the respective left and right lung valves503 and 507 is useful for actuating the simulated respiratory system 213between a spontaneous breathing configuration and an assisted breathingconfiguration, as described in further detail herein.

The compliance control valve 509 includes fluid ports P10, P11, and P12,and is actuable between a first configuration, in which the port P10communicates with the port P11, but not the port P12, and a secondconfiguration, in which the port P10 communicates with the port P12, butnot the port P11. The port P10 is in fluid communication with thechamber 529 of the right lung pump 505 via at least a first part of theflow path L12, and the port P11 is in fluid communication with thesimulated right lung 519 via at least a second part of the flow pathL12. Thus, when the compliance control valve 509 is in the firstconfiguration, in which the port P10 communicates with the port P11, butnot the port P12, the compliance control valve 509 forms at least athird part of the flow path L12. The port P12 of the compliance controlvalve 509 may be in fluid communication with both of the left and rightlung compliance reservoirs 517 and 521— in such embodiments, when thecompliance control valve 509 is in the second configuration, in whichthe port P10 communicates with the port P12, but not the port P11, thechamber 529 of the right lung pump 505 is in fluid communication withboth of the left and right lung compliance reservoirs 517 and 521. Theright lung pump 505 is thus operable, when the compliance control valve509 is in the second configuration, to change the lung compliance of thesimulated left and right lungs 515 and 519 by adjusting the volume ofair within the left and right lung compliance reservoirs 517 and 521.

In addition to, or instead of, the compliance control valve 509 forminga part of the flow path L12, the compliance control valve 509 (oranother compliance control valve) may form a part of the flow path L10so that the left lung pump 501 is operable to change the lung complianceof one, or both, of the simulated left and right lungs 515 and 519. Inthose embodiments including both compliance control valves, the left andright lung pumps 501 and 505 may be configured to communicate jointly,or separately, with the respective left and right lung compliancereservoirs 517 and 521. For example, in one such embodiment, the leftlung pump 501 is operable to change the lung compliance of the simulatedleft lung 515 by adjusting the volume of air within the left lungcompliance reservoir 517, and the right lung pump 505 is operable tochange the lung compliance of the simulated right lung 519 by adjustingthe volume of air within the right lung compliance reservoir 521.

In some embodiments, the simulated airway system 513 is configured forinsertion of one or more tracheal intubation devices. In someembodiments, the simulated airway system 513 may include a tracheatubing depth sensor operably coupled to a simulated trachea to ensureproper execution of various intratracheal training procedures. In someembodiments, the simulated airway system 513 is shaped to facilitate atraining procedure for the insertion and placement of a laryngeal maskairway adjacent the simulated trachea and/or a simulated esophagus. Insome embodiments, the simulated airway system 513 is shaped tofacilitate a training procedure for nasotracheal intubation. In someembodiments, the simulated airway system 513 is shaped to facilitate atraining procedure for the insertion and placement of a nasogastricfeeding tube. In some embodiments, the simulated respiratory system 213and the simulated airway system 513, in combination, enable realisticpulmonary feedback during various training procedures, such as, forexample, a training procedure for endotracheal intubation, a trainingprocedure for a valve bag mask ventilation, or another trainingprocedure described herein.

To place the simulated respiratory system 213 in the spontaneousbreathing configuration, the left and right lung valves 503 and 507 areclosed, and the compliance control valve 509 is actuated to the firstconfiguration, in which the port P10 communicates with the port P11, butnot the port P12. Accordingly, each downward stroke of the left lungpump 501's piston 525 forces air from the chamber 529 into the simulatedleft lung 515 via the flow path L10, and produces a negative (vacuum)pressure in the airway system 513; and each upward stroke of the leftlung pump 501's piston 525 draws air out of the simulated left lung 515into the chamber 529 via the flow path L10 and produces a positivepressure in the airway system 513. Similarly, when the compliancecontrol valve 509 is in the first configuration, in which the port P10communicates with the port P11, but not the port P12, each downwardstroke of the right lung pump 505's piston 525 forces air from thechamber 529 into the simulated right lung 519 via the flow path L12, andproduces a negative (vacuum) pressure in the airway system 513; and eachupward stroke of the right lung pump SOS's piston 525 draws air out ofthe simulated right lung 519 into the chamber 529 via the flow path L12and produces a positive pressure in the airway system 513. As a result,the upward and downward strokes of the respective pistons 525 of theleft lung pump 501 and the right lung pump 505 (i.e., when thecompliance control valve 509 is in the first configuration) simulate therise and fall of a patient's chest cavity, and cause the airway system513 to inhale and exhale in a manner that simulates a patient'sbreathing pattern. The respiratory rate at which each of left and rightlung pumps 501 and 505 is driven may be controlled individually by themicroprocessor circuit 203.

To place the simulated respiratory system 213 in the assisted breathingconfiguration, the left and right lung valves 503 and 507 are at leastpartially opened, and the compliance control valve 509 is actuated tothe first configuration, in which the port P10 communicates with theport P11, but not the port P12. The simulated airway system 513 isplaced in communication with a ventilator. The partial opening of theleft and right lung valves 503 and 507 causes the upward and downwardstrokes of the respective pistons 525 of the left and right lung pumps501 and 505 to produce a pressure fluctuation in the airway system 513that simulates a patient gasping for breath. This pressure fluctuationcan be sensed by the ventilator operably coupled to the airway system513, which ventilator is then activated to assist (i.e., ventilate) thesimulated respiratory system 213.

More particularly, each downward stroke of the left lung pump 501'spiston 525 produces a negative (vacuum) pressure in the airway system513 while permitting the escape of air from the fluid line L10 to theairway system 513 via the partially opened left lung valve 503; and eachupward stroke of the left lung pump 501's piston 525 produces a positivepressure in the airway system 513 while permitting the escape of airfrom the airway system 513 to the fluid line L10 via the partiallyopened left lung valve 503. Similarly, each downward stroke of the rightlung pump 505's piston 525 produces a negative (vacuum) pressure in theairway system 513 while permitting the escape of air from the fluid lineL12 to the airway system 513 via the partially opened right lung valve507; and each upward stroke of the right lung pump SOS's piston 525produces a positive pressure in the airway system 513 while permittingthe escape of air from the airway system 513 to the fluid line L12 viathe partially opened right lung valve 507. The escape of air through thepartially opened left and right lung valves 503 and 507 simulates apatient gasping for breath, which activates the ventilator. Optionally,before, during, or after the ventilator has been activated to assist(i.e., ventilate) the simulated respiratory system 213, the respectivepistons 525 of the left and right lung pumps 501 and 505 can be lockedinto position so that air flowing from the ventilator to the simulatedleft and right lungs 515 and 519 simulates the rise and fall of apatient's chest cavity.

In some embodiments, before, during, or after the ventilator has beenactivated to assist (i.e., ventilate) the simulated respiratory system213, the left and right lung valves 503 and 507 can each be used toadjust airway resistance—such adjustments are readily detectable by theventilator. For example, the left and right lung valves 503 and 507 maybe adjustable between a closed configuration, one or morepartially-opened configurations, and a fully-opened configuration inorder to precisely control airway resistance. In some embodiments, one,or both, of the left and right lung valves 503 and 507 are needlevalves. In some embodiments, before, during, or after the ventilator hasbeen activated to assist (i.e., ventilate) the simulated respiratorysystem 213, the compliance control valve 509 can be actuated to thesecond configuration, in which the port P10 communicates with the portP12, but not the port P11, to change the lung compliance of thesimulated left and right lungs 515 and 519 by adjusting the volume ofair within the left and right lung compliance reservoirs 517 and521—such volume adjustments change the effective volume of the simulatedleft and right lungs 515 and 519. This ability to change the lungcompliance of the simulated left and right lungs 515 and 519realistically simulates the anatomical and physiological phenomenaassociated with the clinical presentation of lung compliance and itsrelated complications.

When entilatio initiated, applied PEEP is usually one of the firstventilator settings chosen it is set directly on the ventilator. A smallamount of applied PEEP (4 to 5 cmH2O) is used in most mechanicallyventilated patients to mitigate end-expiratory alveolar collapse. Ahigher level of applied. PEEP (>5 cmH2O) is sometimes used to improvehypoxemia or reduce ventilator-associated lung injury in patients withacute lung injury, acute respiratory distress syndrome, or other typesof hypoxemic respiratory failure. The amount of air pressure required togenerate a given airflow to the simulated left and right lungs 515 and519 is a function of airway resistance (which can be adjusted using theleft and right lung valves 503 and 507), available volume and/orelasticity of the simulated left and right lungs 515 and 519 (which canbe adjusted by inflating or deflating the left and right lung compliancereservoirs 517 and 521), and/or the location of additional surroundingelements (e.g., the chest wall, etc.).

When PEEP is applied by the ventilator, the simulated left and rightlungs 515 and 519 are pre-inflated by the ventilator at the start ofeach inspiration—this pre-inflation of the simulated left and rightlungs 515 and 519 reduces the remaining available volume within thesimulated left and right lungs 515 and 519, which increases the amountof air pressure required for the ventilator to inspire a set volume ofair into the simulated left and right lungs 515 and 519. As a result,absent correction, the ventilator could display an inaccurately highpressure measurement. In this regard, the PEEP control system 511 isoperable to ensure that the patient simulator 201 (which may beimplemented within the environment and/or the manikin 101) responds tothe PEEP applied by the ventilator as a human patient, as described infurther detail herein.

Referring back again to FIG. 2, in some embodiments, the PEEP controlsystem 511 includes one, or a combination, of the following: an airwaypressure sensor 531 and/or a PEEP control valve 533, each configured forelectronic communication with the microprocessor 203. For example,turning again to FIG. 8, with continuing reference to FIG. 2, in atleast one embodiment, the PEEP control system 511 includes thecombination of: the airway pressure sensor 531 and the PEEP controlvalve 533. The airway pressure sensor 531 is operably coupled to thesimulated airway system 513 and configured to continuously detect theair pressure therewithin. The airway pressure sensor 531's continuousdetection of the air pressure within the simulated airway system 513enables the microprocessor circuit 203 to determine when PEEP is appliedby the ventilator. As shown in FIG. 8, the PEEP control system 511 mayalso include a PEEP reservoir 535. In some embodiments, the PEEPreservoir 535 is a silicone rubber bag. The PEEP control valve 533 isconfigurable to communicate fluid from the simulated airway system 513to the PEEP reservoir 535, or vice versa. For example, the PEEP controlvalve 533 may be adjustable between a closed configuration, one or morepartially-opened configurations, and a fully-opened configuration inorder to precisely control airway resistance between the simulatedairway system 513 and the PEEP reservoir 535. In some embodiments, thePEEP control valve 533 is a needle valve.

In operation, for example, the ventilator may be set to deliver a givenvolume of air (e.g., 120cc) to the simulated left and right lungs 515and 519. During normal ventilation, delivery of this given volume of air(120cc in this case) to the simulated left and right lungs 515 and 519causes the ventilator to display a baseline pressure measurement (e.g.,15cmH2O). Using the ventilator, PEEP can then be applied to pre-inflatethe simulated left and right lungs 515 and 519 to an applied PEEPsetting (e.g., 5cmH2O) before delivering the set volume of air (120cc inthis case) to the simulated left and right lungs 515 and 519. Toaccurately simulate a human patient's response to the applied PEEP, theventilator should display a PEEP pressure measurement approximatelyequal to the sum of the baseline pressure measurement (15cmH2O in thiscase) and the applied PEEP setting (5cmH2O in this case). However, theapplied PEEP causes a reduction in the remaining available volume withinthe simulated left and right lungs 515 and 519. As a result, delivery ofthe set volume of air (120cc in this case) to the simulated left andright lungs 515 and 519 could cause the ventilator to display a PEEPpressure measurement (e.g., 25cmH2O) that is greater than the sum of thebaseline pressure measurement (15cmH2O in this case) and the appliedPEEP setting (5cmH2O in this case). To correct this difference, when themicroprocessor circuit 203 determines that PEEP has been applied (i.e.,based on the airway pressure sensor 531's continuous detection of theair pressure within the simulated airway system 513), the PEEP controlvalve 533 is at least partially opened to permit a portion of the setvolume of air (120cc in this case) to be communicated into the PEEPreservoir 535. This reduces the ventilator's PEEP pressure measurementto an amount that is approximately equal to the sum of the baselinepressure measurement (15cmH2O in this case) and the applied PEEP setting(5cmH2O in this case).

In addition to, or instead of, the PEEP control valve 533 and the PEEPreservoir 535, the PEEP control system 511 may include one or more otherPEEP control valve(s) and/or one or more other PEEP reservoir(s)configured to communicate with the simulated airway system 513. The oneor more other PEEP reservoir(s) may have different volumes from eachother and/or the PEEP reservoir 535 in order to accommodate differencelevels of applied PEEP.

Referring back again to FIG. 1, in some embodiments, the manikin 101includes a capillary device 601 connected to the simulated hand 111 aand/or 111 b. Turning to FIGS. 9 and 10, with continuing reference toFIG. 1, in some embodiments, the capillary device 601 includes asimulated fingertip 603, a fitting 605, a sealing ring 607, and a cap609. The simulated fingertip 603 defines an internal chamber 611configured to receive simulated blood. The internal chamber 611 may beformed so that the wall thickness of the simulated fingertip 603 varies.In this regard, the thinnest portion of the simulated fingertip 603'swall is located at the position where a glucose lancet is supposed to beplaced to draw simulated blood. In some embodiments, the simulatedfingertip 603 is made of silicone rubber. The fitting 605 includes aninternal passage 613, and is sized and shaped to fit into an end portionof the simulated fingertip 603 so that the internal passage 613 is influid communication with the internal chamber 611 of the simulatedfingertip 603. In some embodiments, the fitting 605 is affixed to thesimulated fingertip 603 with an adhesive (e.g., glue). An end portion615 of the fitting 605 opposite the simulated fingertip 603 isconfigured to engage, or be connected, with the remainder of thesimulated hand 111 a and/or 111 b. In some embodiments, the fitting 605is a machined plastic tube. The sealing ring 607 and the cap 609 areengageable with the fitting 605 at the end portion 615 to seal simulatedblood within the internal passage 613 of the fitting 605 and theinternal chamber 611 of the simulated fingertip 603. In someembodiments, the cap 609 is threaded.

The capillary device 601 is operable to realistically simulate a fingerstick procedure, which is commonly performed in clinical settings toobtain a small quantity of capillary blood for testing. The user fillsthe capillary device 601 by removing the cap 609 and introducingsimulated blood into the internal passage 613 of the fitting 605. Oncethe internal chamber 611 of the simulated fingertip 603 is filled withsimulated blood, the cap 609 can be restored and the capillary device601 can be used to simulate the finger stick procedure. Moreparticularly, to simulate the finger stick procedure, the user sticksthe simulated fingertip 603 with a lancet and squeezes simulated bloodout through the puncture. In some embodiments, the simulated fingertip603 is filled with simulated blood mixed with a desired amount of sugarto facilitate a finger stick procedure for the testing and diagnosis ofdiabetes. In some embodiments, the capillary device 601 is disposable.In some embodiments, a small amount of absorbent material (e.g., cottonor the like) may be added into the internal chamber 611 of the simulatedfingertip 603 to increase the consistency and volume of the simulatedblood and to permit the simulated blood to be squeezed out of theabsorbent material through the needle picking site while preventing, orat least reducing, the simulated fingertip 603 from being “squashed”when the simulated blood is squeezed out.

In various embodiments, the patient simulator 201 (which may beimplemented at least in part within the environment and/or the manikin101) includes one or more features as provided in medical simulatorsprovided by Gaumard Scientific Company, Inc. based out of Miami, Fla.,including but not limited to the following models: S1000 Hal®, S1020Hal®, S1030 Hal®, S3000 Hal®, S2000 Susie®, S221 Clinical Chloe®, S222Clinical Chloe®, S222.100 Super Chloe®, S303 Code Blue®, S304 CodeBlue®, S100 Susie®, S100 Simon®, S200 Susie®, S200 Simon®, S201 Susie®,S201 Simon®, S203 Susie®, S204 Simon®, S205 Simple Simon®, S206 SimpleSusie®, S3004 Pediatric Hal®, S3005 Pediatric Hal®, S3009 Premie Hal®,S3010 Newborn Hal®, S110 Mike®, S110 Michelle®, S150 Mike®, S150Michelle®, S107 Multipurpose Patient Care and CPR Infant Simulator, S117Multipurpose Patient Care and CPR Pediatric Simulator, S157 MultipurposePatient Care and CPR Pediatric Simulator, S575 Noelle®, S565 Noelle®,S560 Noelle®, S555 Noelle®, S550 Noelle®, S550.100 Noelle®, S2200Victoria®, S2220 Super Tory®, and/or other patient simulators.

The present disclosure introduces a patient simulator, including asimulated thoracic site configured for insertion of a chest tubethereinto, or therethrough, to facilitate a simulated thoracostomyprocedure; and a chest fluid reservoir configured to communicatesimulated pleural fluid to the chest tube after insertion of the chesttube into, or through, the simulated thoracic site. In variousembodiments, the patient simulator further includes a chest fluid valveincluding a first port in fluid communication, via a first flow path,with the simulated thoracic site, and a second port in fluidcommunication, via a second flow path, with the chest fluid reservoir;wherein the chest fluid valve is actuable between a first configuration,in which the first port is in fluid communication with the second port,and a second configuration, in which the first port is not in fluidcommunication with the second port. In various embodiments, the patientsimulator further includes a chest tube sensor configured to detectinsertion of the chest tube into, or through, the simulated thoracicsite. In various embodiments, the patient simulator further includes amicroprocessor configured to actuate the chest fluid valve to the firstconfiguration based on the detecting of the insertion of the chest tubeinto, or through, the simulated thoracic site by the chest tube sensor.In various embodiments, the chest fluid valve further includes a thirdport with which the second port is in fluid communication when the chestfluid valve is in the second configuration; and the third port is influid communication, via a third flow path, with a filling port so thatthe chest fluid reservoir is replenishable via at least the filling portand the second and third flow paths when the chest fluid valve is in thesecond configuration. In various embodiments, the chest fluid reservoirincludes an expandable vessel in fluid communication, via the secondflow path, with the second port of the chest fluid valve, the expandablevessel being actuable between a fully-collapsed state and afully-expanded state; and a biasing member configured to bias theexpandable vessel towards the fully-collapsed state to facilitate thecommunication of the simulated pleural fluid to the simulated thoracicsite. In various embodiments, the simulated thoracic site includes asupport housing and an insert that is detachably connectable to thesupport housing. In various embodiments, the insert includes one, or acombination, of the following: a simulated skin layer, a simulatedadipose tissue layer, a simulated ribs layer, a simulated endothoracicfascia layer, and/or a pleura cavity layer.

The present disclosure also introduces a patient simulator, including asimulated catheterization site configured for insertion of a catheterthereinto, or therethrough, to facilitate a simulated urinarycatheterization procedure; and a first urinary fluid reservoirconfigured to communicate simulated urinary fluid, via at least a firstflow path, to the catheter after the catheter has been inserted into, orthrough, the simulated catheterization site. In various embodiments, thepatient simulator further includes a check valve operably coupled to thesimulated catheterization site and configured to receive the catheterafter the catheter has be inserted into, or through, the simulatedcatheterization site; wherein the first urinary fluid reservoir ispermitted to release an initial surge of simulated urinary fluid intothe catheter once the catheter has been received by the check valve. Invarious embodiments, the first urinary fluid reservoir includes anexpandable vessel configured to be in fluid communication, via at leastthe first flow path, with the catheter once the catheter has beenreceived by the check valve, the expandable vessel being actuablebetween a fully-collapsed state and a fully-expanded state; and abiasing member configured to bias the expandable vessel towards thefully-collapsed state to facilitate the communication of the simulatedurinary fluid to the catheter. In various embodiments, the patientsimulator further includes a second urinary fluid reservoir configuredto communicate simulated urinary fluid, via at least a second flow path,to the catheter after the catheter has been inserted into, or through,the simulated catheterization site. In various embodiments, the patientsimulator further includes a urinary valve including a first port influid communication, via at least a third flow path, with the simulatedcatheterization site, and a second port in fluid communication, via thesecond flow path, with the second urinary fluid reservoir; wherein theurinary valve is actuable between a first configuration, in which thefirst port is in fluid communication with the second port, and a secondconfiguration, in which the first port is not in fluid communicationwith the second port. In various embodiments, when the urinary valve isin the first configuration and the catheter has been received by thecheck valve, the second urinary fluid reservoir is permitted to releaseadditional simulated urinary fluid into the catheter. In variousembodiments, the second urinary fluid reservoir includes an expandablevessel configured to be in fluid communication, via at least the secondand third flow paths, with the catheter once the catheter has beenreceived by the check valve and the urinary valve has been actuated tothe first configuration, the expandable vessel being actuable between afully-collapsed state and a fully-expanded state; and a biasing memberconfigured to bias the expandable vessel towards the fully-collapsedstate to facilitate the communication of the additional simulatedurinary fluid to the catheter. In various embodiments, the patientsimulator further includes a microprocessor configured to actuate theurinary valve to the first configuration after the initial surge ofsimulated urinary fluid has been released from the first urinary fluidreservoir into the catheter. In various embodiments, the simulatedcatheterization site includes either a simulated male urethral openingor a simulated female urethral opening.

The present disclosure also introduces a patient simulator, including alung pump including a cylinder and a piston dividing the cylinder intofirst and second chambers, the piston being adapted to reciprocatewithin the cylinder; a simulated lung in fluid communication, via afirst flow path, with the first chamber of the lung pump; and an airwaysystem to which a mechanical ventilator is operably couplable, theairway system being in fluid communication, via a second flow path, withthe second chamber of the lung pump. In various embodiments, the patientsimulator further includes a compliance control valve having first,second, and third ports, and being actuable between a firstconfiguration, in which the first port is in fluid communication withthe second port, but not the third port, and a second configuration, inwhich the first port is in fluid communication with the third port, butnot the second port; wherein the first port is in fluid communication,via at least a portion of the second fluid path, with the first chamberof the lung pump; and wherein the second port is in fluid communication,via at least another portion of the second fluid path, with thesimulated lung. In various embodiments, the patient simulator furtherincludes a first lung compliance reservoir positioned adjacent thesimulated lung. In various embodiments, the first lung compliancereservoir is in fluid communication with the third port of thecompliance control valve so that, when the compliance control valve isin the second configuration, a volume of air within the first lungcompliance reservoir can be adjusted to change the lung compliance ofthe simulated lung.

It is understood that variations may be made in the foregoing withoutdeparting from the scope of the present disclosure.

In various embodiments, the elements and teachings of the variousembodiments may be combined in whole or in part in some or all of thevarious embodiments. In addition, one or more of the elements andteachings of the various embodiments may be omitted, at least in part,and/or combined, at least in part, with one or more of the otherelements and teachings of the various embodiments.

In various embodiments, while different steps, processes, and proceduresare described as appearing as distinct acts, one or more of the steps,one or more of the processes, and/or one or more of the procedures mayalso be performed in different orders, simultaneously and/orsequentially. In various embodiments, the steps, processes and/orprocedures may be merged into one or more steps, processes and/orprocedures.

In various embodiments, one or more of the operational steps in eachembodiment may be omitted. Moreover, in some instances, some features ofthe present disclosure may be employed without a corresponding use ofthe other features. Moreover, one or more of the above-describedembodiments and/or variations may be combined in whole or in part withany one or more of the other above-described embodiments and/orvariations.

In the foregoing description of certain embodiments, specificterminology has been resorted to for the sake of clarity. However, thedisclosure is not intended to be limited to the specific terms soselected, and it is to be understood that each specific term includesother technical equivalents which operate in a similar manner toaccomplish a similar technical purpose. Terms such as “left” and right“,“front” and “rear”, “above” and “below” and the like are used as wordsof convenience to provide reference points and are not to be construedas limiting terms.

In this specification, the word “comprising” is to be understood in its“open” sense, that is, in the sense of “including”, and thus not limitedto its “closed” sense, that is the sense of “consisting only of”. Acorresponding meaning is to be attributed to the corresponding words“comprise”, “comprised” and “comprises” where they appear.

Although various embodiments have been described in detail above, theembodiments described are illustrative only and are not limiting, andthose skilled in the art will readily appreciate that many othermodifications, changes and/or substitutions are possible in the variousembodiments without materially departing from the novel teachings andadvantages of the present disclosure. Accordingly, all suchmodifications, changes, and/or substitutions are intended to be includedwithin the scope of this disclosure as defined in the following claims.In the claims, any means-plus-function clauses are intended to cover thestructures described herein as performing the recited function and notonly structural equivalents, but also equivalent structures. Moreover,it is the express intention of the applicant not to invoke 35 U.S.C. §112, paragraph 6 for any limitations of any of the claims herein, exceptfor those in which the claim expressly uses the word “means” togetherwith an associated function.

What is claimed is:
 1. A patient simulator, comprising: a simulatedcatheterization site configured for insertion of a catheter thereinto,or therethrough, to facilitate a simulated urinary catheterizationprocedure; and a first urinary fluid reservoir configured to communicatesimulated urinary fluid, via at least a first flow path, to the insertedcatheter.
 2. The patient simulator of claim 1, further comprising acheck valve operably coupled to the simulated catheterization site andconfigured to receive the inserted catheter; wherein the first urinaryfluid reservoir is permitted to release an initial surge of simulatedurinary fluid into the catheter when the catheter has been received bythe check valve.
 3. The patient simulator of claim 2, wherein the firsturinary fluid reservoir is biased from an expanded state towards acollapsed state to release the initial surge of simulated urinary fluidinto the catheter when the catheter has been received by the checkvalve.
 4. The patient simulator of claim 2, further comprising a secondurinary fluid reservoir configured to communicate simulated urinaryfluid, via at least a second flow path, to the inserted catheter.
 5. Thepatient simulator of claim 4, further comprising: a urinary valveincluding a first port in fluid communication, via at least a third flowpath, with the simulated catheterization site, and a second port influid communication, via the second flow path, with the second urinaryfluid reservoir; wherein the urinary valve is actuable between a firstconfiguration, in which the first port is in fluid communication withthe second port, and a second configuration, in which the first port isnot in fluid communication with the second port.
 6. The patientsimulator of claim 5, wherein, when the urinary valve is in the firstconfiguration and the catheter has been received by the check valve, thesecond urinary fluid reservoir is permitted to release additionalsimulated urinary fluid into the catheter.
 7. The patient simulator ofclaim 6, wherein the second urinary fluid reservoir is biased from anexpanded state towards a collapsed state to release the additionalsimulated urinary fluid into the catheter when the urinary valve is inthe first configuration and the catheter has been received by the checkvalve.
 8. The patient simulator of claim 5, further comprising amicroprocessor configured to actuate the urinary valve to the firstconfiguration after the initial surge of simulated urinary fluid hasbeen released from the first urinary fluid reservoir into the catheter.9. The patient simulator of claim 1, wherein the simulatedcatheterization site comprises either a simulated male urethral openingor a simulated female urethral opening.
 10. A method, comprising:inserting a catheter into, or through, a simulated catheterization siteto facilitate simulation of a urinary catheterization procedure; andcommunicating, via a first flow path, simulated urinary fluid from afirst urinary fluid reservoir to the inserted catheter.
 11. The methodof claim 10, wherein communicating, via the first flow path, thesimulated urinary fluid from the first urinary fluid reservoir to theinserted catheter comprises: receiving the inserted catheter using acheck valve operably coupled to the simulated catheterization site; andreleasing an initial surge of the simulated urinary fluid from the firsturinary fluid reservoir into the received catheter.
 12. The method ofclaim 11, wherein releasing the initial surge of the simulated urinaryfluid from the first urinary fluid reservoir into the received cathetercomprises: biasing the first urinary fluid reservoir from an expandedstate towards a collapsed state.
 13. The method of claim 11, furthercomprising: communicating, via a second flow path, simulated urinaryfluid from a second urinary fluid reservoir to the inserted catheter.14. The method of claim 13, wherein communicating, via the second flowpath, the simulated urinary fluid from the second urinary fluidreservoir to the inserted catheter comprises: actuating a urinary valve,which includes a first port in fluid communication, via at least a thirdflow path, with the simulated catheterization site, and a second port influid communication, via the second flow path, with the second urinaryfluid reservoir: to a first configuration, in which the first port is influid communication with the second port; from a second configuration,in which the first port is not in fluid communication with the secondport.
 15. The method of claim 14, wherein communicating, via the secondflow path, the simulated urinary fluid from the second urinary fluidreservoir to the inserted catheter further comprises: in response toactuating the urinary valve to the first configuration from the secondconfiguration, releasing additional simulated urinary fluid from thesecond urinary fluid reservoir into the received catheter.
 16. Themethod of claim 15, wherein releasing the additional simulated urinaryfluid from the second urinary fluid reservoir into the received cathetercomprises: biasing the second urinary fluid reservoir from an expandedstate towards a collapsed state.
 17. The method of claim 14, wherein amicroprocessor actuates the urinary valve to the first configurationfrom the second configuration after the initial surge of simulatedurinary fluid has been released from the first urinary fluid reservoirinto the received catheter.
 18. The method of claim 10, wherein thesimulated catheterization site comprises either a simulated maleurethral opening or a simulated female urethral opening.